Development of a Measure to Evaluate the Quality of Dementia Care Provided by Caregivers at Unit Care Geriatric Health Service Facilities

This study was conducted to develop a measure for evaluating the quality of dementia care provided by caregivers in unit care geriatric health service facilities in Japan. A secondary factor model consisting of the following factors was used in the study. Primary factors were: "Creating a safe environment with a home-like atmosphere," "Helping residents maintain their ordinary life," "Helping maintain and improve the lifestyles of individual residents," "Providing support in a way that respects each resident\u27s unique personality," "Encouraging social interaction with others" and "Maintaining family relationships," and one secondary factor, "Quality of dementia care." The construct validity of the above measure was assessed in terms of the relationship between the factor model and an external criterion using structural equation modeling (SEM) based on data from 984 caregivers. Job satisfaction was used as the external criterion. As a result, the fit of the factor model to the data and the relationship between dementia care quality and job satisfaction were statistically supported. The Cronbach alpha coefficient for the measure was within statistically permissible limits. Based on the above results, we concluded that the measure to evaluate dementia care quality that was developed in the study is effective for evaluating the quality of dementia care provided by caregivers in unit care geriatric health service facilities

Relationships between Dementia Care Duties and the Job Satisfaction of Nursing Staff in Unit-type Geriatric Health Service Facilities

This study examined the relationship between the frequency of high-quality dementia care duties and job satisfaction among nursing employees working in unit care geriatric health service facilities, including the perceived difficulty of performing care and responses to difficult work situations. Self-administered questionnaires were distributed to a total of 608 subjects. 324 effective responses were received and analyzed. A causal model was proposed in which the frequency of high-quality dementia care is influenced by the perceived difficulty of practicing such care, and that these two factors, mediated by control and escapes responses, affect job performance. Structural equation modeling was employed for assessment of fit and to evaluate the relationships between variables. After confirming that the proposed model fitted the data, it was found that high-quality dementia care is indeed associated with the perceived difficulty of practicing such care and that these two factors, mediated by control responses, are associated with job satisfaction. The results indicate that sustaining and increasing job satisfaction requires adopting control-oriented responses and improving the quality of dementia care

英国の高齢者を支えるボランティアパワー

英国のボランタリー団体の1つであるエイジコンサーンにて平成9年2月17日から3月17日まで約1ヶ月間の研修をし体験したことを報告する。英国におけるボランタリー団体の位置づけや社会的役割、またエイジコンサーンの活動の概要から高齢者福祉の現状を整理した。高齢者の自立した生活を支えるために多くのボランティアが働き、そのボランティアを動かすシステムについてまとめた

Metastatic Breast Cancer to the Stomach Resembling Early Gastric Cancer

Breast cancer metastases to the stomach are very rare. As characteristics of breast cancer metastases to the stomach, metastases of lobular carcinoma, mainly with signet ring cells, are frequently observed, and they are often difficult to distinguish from a primary gastric cancer with signet ring cells. Moreover, because no characteristic symptoms are shown and they involve a submucosal lesion, it is difficult to make a radiographic diagnosis. However, if a gastric lesion is observed after breast carcinoma surgery, differentiation between a gastric primary lesion and a metastatic lesion is very important in order to determine treatment. We encountered a case that was diagnosed as early gastric cancer discovered using an endoscope 2 years after surgery and which was found to be breast cancer metastasis to the stomach by gross cystic disease fluid protein (GCDFP) and cytokeratin (CK) 7/20 immunostaining of the biopsy tissue. Here, we report our findings of this unique case

Endometrial Metastasis from Breast Cancer during Adjuvant Endocrine Therapy

It is well-known that tamoxifen increases the risk of endometrial cancer. Although metastasis to the uterus from breast cancer is uncommon, there have been some case reports on uterine metastasis. If an endometrial abnormality is detected, the differential diagnosis of whether the uterine tumor is metastatic or primary is very important to determine the course of treatment. We herein report a case in which we detected a uterine tumor during follow-up after treatment with tamoxifen, and demonstrate that GCDFP-15 is useful in diagnosing metastatic uterine tumors arising from breast cancer

看護学生の老人のイメージについて

本研究は、老年人口割合の高い地域における看護学生の老人イメージを明らかにすること、それによって老人看護の学習を進めていくための示唆を得ようとするものである。調査の結果、学生の身体機能に関する老人イメージは否定的イメージが多かったが、社会的存在としての老人イメージは老人が生き生きと活動しているものが多く、また老人の自己決定を尊重し、老人を受け入れる態度があった。これは三世帯家族の割合の高さや老人と日頃身近にふれあう体験によるものと考えられる

脳卒中登録システムに基づく高齢者の地域ケアに関する研究

島根県は、県下を網羅した全国でも数少ない脳卒中等情報システムを保健所を核にして1993年から実施した。県下10保健所での脳卒中等情報システムに関する調査を1997年に実施した。1994年～1996年の10保健所における脳卒中発症登録者は3、185人、退院登録者は1、146人であった。発症登録結果から、脳卒中の第1次予防として、男性、特に70歳以上の高齢者の脳梗塞と女性のくも膜下出血へ対策が重要であることが示された。退院登録から、脳卒中後遺症が軽症の割合が高率であるが、再発予防との関連での検討と、日常生活動作に介助が必要な重い程度の人達への地域でのサービス提供体制の充実の必要性が示された